Anomalous left adrenal venous drainage directly into the inferior vena cava

Primary hyperaldosteronism is a potential cause of hypertension. Unilateral adrenal adenoma and bilateral adrenal cortical hyperplasia are the most co mmon causes of primary hyperaldosteronism. Adrenal venous sampling is emplo yed as the gold standard test to differentiate between these two different causes when the results of other studies in the work-up protocol are non-di agnostic or ambiguous. Adrenal venous sampling can be a challenging procedu re, especially in the presence of anomalous venous drainage patterns. Knowl edge of normal adrenal venous anatomy, as well as possible variants, is the refore important to ensure a successful procedure. The authors describe an unusual variant of left adrenal venous drainage directly into the IVC.